True or false? An otherwise healthy toddler with a clear, runny nose, dry cough, and under-the-arm temperature of 97 degrees Fahrenheit should be sent home sick from daycare until symptoms improve. In a recent survey of over 300 daycare center directors in Wisconsin, more than half would send the child home, despite established guidelines from the American Academy of Pediatrics (AAP) that call exclusion for this type of mild illness unnecessary.
Published in the May 2010 issue of the journal Pediatrics, the survey described symptoms of five hypothetical children, all of whom were otherwise acting happy and well: a 3-year-old with a runny nose and no fever; a 4-year-old with conjunctivitis (pink eye); a toilet-trained 2-year-old with mild diarrhea and vomiting; a 3-year-old with a 101-degree fever but no other symptoms; and a 4-year-old with a fungal scalp infection. None of these conditions pose a major threat to other children, notes lead researcher Andrew Hashikawa of the Medical College of Wisconsin in Milwaukee in a USA Today article on the study. But according to survey results, 57 percent of directors would opt to send these children home.
State guidelines may vary, but according to the AAP, sick children should be kept home when they have:
- Diarrhea or stools that contain blood or mucus
- An illness that caused vomiting two or more times during the previous 24 hours, unless the vomiting is known to be caused by a condition that's not contagious
- Mouth sores with drooling, unless caused by a non-contagious condition
- Impetigo (a skin infection with erupting sores) until 24 hours after treatment has been started
- Head lice (until after proper treatment has been given)
- Scabies (an itchy skin condition caused by mites) until after treatment has been given
- Conditions that suggest the possible presence of a more serious illness, including a fever, sluggishness, persistent crying, irritability, or difficulty breathing
According to Hashikawa, one of the easiest ways to figure out if your child has a mild illness is to check how your child is acting. If he or she is lethargic or needs a lot of attention because of the illness, it's probably best to keep your child home. But, if your child has a runny nose and otherwise seems fine, then the guidelines suggest your child could be in daycare. A working parent's best bet? Discuss sick child exclusion policies with your daycare provider long before that first sniffle.